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Posted by rachel on 19-07-2014 at 01:50:
EW.
Do you mean the insurance company tried to find excuses to force you not to taking zyvox pills? Do I understand right? Your current situation is absolutely stressful to me, too. Because these days Korean Government(actually Senuri-Dang, the ruling party) announced they are going to abandon public medical care system,(PMCS) and proceed privatization of health care. Behind this scheme, there is Sam-Sung. Korean Government is deceiving people saying "We should accept the same medical care system of USA, which is superior than ours. It would enable people to receive more advanced medical services at cheaper price" The major media are being seized by Senuri-Dang, so only young people who care about current issues know this evil plan.
Anyway, all Korean people are being covered by PMCS. Every hospital is under PMCS, too.
My husband and I pay $30, my uncle pays $600 for a month. The cost is depend on one's income. My uncle's income is about 0.5~0.7 million dollars after taxation, for a year. Actually, I pay $0 for PMCS because mandatory PMCS for salary men(my husband) covers all family members. Before I become like my uncle, I can rely on my husband's PMCS.
In the Victoria's posting, I said I do not go to see a doctor unless I get injured physically. It is not matter of money. If I catch cold and visit hospital and pharmacy, doctor charge me $4 and pills for a week is about $3. It is cheaper than Starbucks's americano. For more examples,
-zyvox $60
-cesarean $500
-20~40 Stitches for skin cut, at emergency center $50
-appendectomy operation $300
-staying overnight at emergency center for high fever/stomachaches $30
-finger reconnect operation $400
If I have private medical insurance about $50 per month, all the costs could be $0. The insurance company pays instead of me. My father has private insurance of $80. He caught Malaria during a trip. He stayed three days at emergency room and 7 days in a fine twin room at a large hospital complex. He paid $0. I paid about $300 for him (sushi packs/Starbucks coffees/pizza/organic juice/cookies/news magazines etc) He was lucky that quad rooms were full at the moment. So he had to stay in a twin room so his insurance had to cover all the cost of twin room. If my father chose twin room even though there were a vacant bed in quad room, he would have been charged about $500 for 7 days of twin room. ($1000- 50% my father, 50% private insurance. his insurance covers 100% for quads and 50% for twin&single)
Government forces all hospitals and doctors not to charge more than designated costs. Let me explain a little bit more.
Dental scaling's designated cost is $60. Once a year, PMCS covers 80% the cost. If I have my teeth cleaned twice a year, first time I pay $13 and next time I should pay the whole cost of $60. Dentist can't charge me more than $60. It is just illegal.
My cousin's wife is a dentist and an owner of a dental clinic in Florida. She has three luxurious houses with beautiful swimming pools and every morning she select today's car in her garage just like shoes.
Of course, Korean salary doctors can't earn like her unless if he is an owner of medium-size hospital. But if he wants to buy BMW X6, it is not that much burden though. You may think "how could it be possible? Does every Korean go to see a doctor everyday?". If you're curious about it, I can explain it but I'm going to skip it now.
Except car accident victims(because of insurance fraud), Korean insurance companies barely cares about what doctors do for the patient.
EW you said your insurance company once had tried to find excuses not to cover zyvox, it sounds to me that they're still trying perhaps. If so, I really curse them...so cruel......I hope their attempts would be ended up in fail and you don't need that thing anymore.
These days I'm taking sharp attention to the medical news because the dooms day of PMCS is clearly coming by Senuri-Dang and Samsung. Every major media is horribly silent here. BR's comment also scares me, too. $1500 per month? OMG...
Posted by ChrisW on 19-07-2014 at 02:23:
I was born and grew up in the US, and when I married, I moved to Canada and have lived here for 20 years. US health care is very expensive and the insurers often interfere with what people should be taking (while there are efforts there to improve this, there's a lot of push-back by the insurance industry and right-wing politicians). In some ways the US is tearing itself apart politically in the attempt to move to a socialized, centralized system.
In Canada, while the system isn't perfect, it's a socialized system that everyone belongs to more like the current one in South Korea. I'm sad to hear that they're trying to privatize it like in the US. When I travel to the US I always get the travel health insurance rider so that if something happens while I'm there, I won't end up getting bankrupted. Medications, as I understand it, also tend to be less expensive in Canada than the US because of government bulk discounts? When I moved up here doctors kept apologizing whenever they prescribed something, saying it was expensive, and I'd laugh when I went to pay for it because it cost so much less than I'd expected.
Unfortunately right-wing politicians in Canada keep making noises about privatizing as well. So far that's been prevented. I'm very pleased with the health care I've received since I moved here, and since my husband and I are both self-employed, we could never have afforded to move to the US and pay for our own insurance (or heaven forbid, join the many Americans who have none at all).
I obviously share your strong opinions on the subject, rachel. Hopefully people will wake up over there. A healthy population is a stronger, more productive population. Making health care unaffordable and difficult to obtain is counter-productive. Add onto that that despite the higher cost, etc., the US doesn't do any better at avoiding preventable death due to medical care issues than the rest of the world (from recent medical testimony in the US) ...
I'll stop going on about it now. 
Grumble.
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Posted by jublke on 19-07-2014 at 03:27:
EW: I hope the expensive meds continue to work for you. I'm sorry that your wound recovery has been so hard. (((hugs)))
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Posted by rachel on 19-07-2014 at 03:56:
CW- Yeah, it brings headache and makes me feel depressed. Don't want to think about it anymore.
EW- I don't know your situation and condition exactly so it may sound silly to you. But if you are having troubles for medication costs and staying in home these days, I'd recommend to visit Korea or other countries. Korea provides the same insurance to foreigners Many Korean Americans visit here only to receive medical service. Because it is far cheaper than US. There are lots of medical-trip agencies for Korean Americans. Many of their customers can't speak Korean language, so don't worry about communications. The large hospital complexes in Seoul always welcome foreigners, too. If you want, I can search reliable agency for you.
If you don't need hospital bed, you can stay in a fine residence hotel like this.
-$4000 per month
-one bedroom, two bathroom, small kitchen, living room
-If there is accompany, he/she can use swimming pool/fitness center for free. This is one of the most expensive residential hotel in Seoul.
-ten minutes from second-largest hospital in Korea by car.
-If it's too expensive you can rent a clean and wider apartment house at $1000~2000 in downtown with two bedrooms. And if you fill it with IKEA furniture, you can easily sell them on online before you leave Korea. It also means that you can buy used furniture easily.
I know it is very very hard to make a decision to go to abroad for medical care, where no friends nor relatives exists.
But I hope someday this information could be a bit helpful all Americans here. Although you do not leave US for medical care, I think this information would widen your range of choices and it maybe helpful anyway.
Posted by ElectricWhite on 19-07-2014 at 13:57:
Wow! That looks like a great vacation spot no matter what!
My insurance is covering 100% of the treatment -- if the doctor insists that the treatment is necessary, then the insurance folks will give in; sometimes, though, that back-and-forth between doctor and insurance can cause a delay that lasts just long enough to cause harm to the patient.
Overall, I've got some awesome insurance -- it's better than what I could afford before I became disabled! But there are still some bits of stupidity I've had to deal with from time to time. For instance, one of my meds comes in a strength that I would just have to take once a day. But my insurance wouldn't cover this, but they would cover a weaker version, so I have to take 3 pills at once in order to get the same benefits as the one pill. And when a doctor ordered my first wheelchair, somebody at the insurance company insisted I could get by with a child-sized chair. (And, boy, was that doctor pissed when he had to repeat several times to the moron that a six-foot-tall woman can't use a chair made for a six-year-old!)
It's because of those bits of silliness -- and the fight that I got when I applied to receive my Social Security Disability benefits -- that I don't always have much patience whenever I start getting any amount of run around.
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Posted by ChrisW on 19-07-2014 at 20:48:
Glad to hear you have good insurance, EW. That's a little crazy about the wheelchair! Just imagine how frustrated doctors must get. That's one of the things that annoys me about the system, all the wasted time in that kind of pointless arguing. I'd rather my doctor be spending their time on figuring out what's up with their patients!
Of course a medical system should be conscious of cost, but c'mon.
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Eagle Whisperer
Posted by Becky Rock on 19-07-2014 at 22:28:
I always find the comparisons you give us Rachel to be very interesting.
Do S. Korean doctors have to pay malpractice insurance?
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Posted by rachel on 20-07-2014 at 06:49:
EW- Glad to hear that you are being fully covered!
by the way, you're really tall!! 
BR- No, they don't. Because compensations for medical damages judged by court is laughable. I've searched some examples.
Case 1
A premature baby got injured by too tightened wristband and medication tubes.
His mother found his little finger's nail turned purple.
She called doctor but the doctor regarded it is not serious at all.
After that, she found the baby's finger get worse. So she called doctors several times, finally the doctor loosened the tube. However it was too late. The premature baby had to cut his left wrist.
The court sentenced the doctor to compensate the damage to the baby's parents- $140,000.
If his mother didn't call the doctor lots of times, I think the compensation would be less than half.
Case 2
Lots of Korean young women permanently damaged by plastic surgeries.
If a woman dies during the surgery, hospital usually pays to her family $200,000~$300,000
Case 3
A middle age woman died during operations because doctor mistakenly cut her arteries. $250,000
You may think these little compensations are due to PMCS, but I don't think so.
Posted by Redbird on 20-07-2014 at 18:48:
I'm glad that you finally got your antibiotics approved, EW. Your doctor sounds like he's a great patient advocate!
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Me too BR!
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Unfortunately, I think many of us know that insurance companies are not in the business of paying claims (or for treatment).
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Posted by Victoria on 22-07-2014 at 00:17:
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Yikes, that sounds harsh. What is it with these insurance people? Over here, health insurance is mandatory and doctors prescribe whatever works best, no matter which company pays them. I don't think I've ever heard the insurance people haggle so much over a person's health. I'm keeping my fingers crossed for you, EW, and hope you'll have enough patience not to bird missile them in the face.
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Posted by Becky Rock on 22-07-2014 at 00:24:
That's frightening Rachel.
EW- As long as you get what you need, that's what's important.
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Posted by ElectricWhite on 24-07-2014 at 13:14:
Well, the wound on my leg has had a major turn-around! There was almost no seepage this time, so Dr. Mehmood decided to apply a type of mesh that's used for conditions ranging from severe Poison Ivy to burns. Let me make this clear: I DID get the mesh...however, some insurance company silliness came into play.
The nurse who was in charge of ordering the stuff explained it to me. Normally, the larger the square that's ordered, the lower the cost. That would have worked out great for me -- two 5-inch squares would have covered the area perfectly. The insurance refused to pay -- they only approve that size when it's used in the operating room. But they approved a smaller size.
I know my jaw dropped when a nurse came in with a huge pile of individually-wrapped mesh squares. The size that was approved was slightly larger than a postage stamp. So, while I watched Dr. Mehmood and two nurses apply those itty-bitty bits of mesh, I could hear a little *dink! dink! dink!* sound effect in my mind. 
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Posted by Kritter on 24-07-2014 at 15:38:
You know the absurd thing here is those two 5 inch squares would have been cheaper than that huge pile of tiny ones. Penny wise and pound foolish! Glad you leg is getting better though.
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Posted by Becky Rock on 24-07-2014 at 18:14:
I can only shake my head. I agree with Kritter. As long as you're getting better, that's what's important.
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Posted by ChrisW on 24-07-2014 at 20:15:
EW since I know our personalities are similar, I'll share a motto of mine ... Cultivate Morbid Amusement ... I'm glad they approved the mesh in some form, even if they were stupid about it!
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Posted by ElectricWhite on 24-07-2014 at 20:47:
CW -- It was sooooo hard for me to keep from laughing as I watched the mesh squares being put on -- it seemed more like a clip from a cartoon or a silly video game (hence the *dink! dink! dink!* sound effect in my head!)
__________________
“There are worse crimes than burning books. One of them is not reading them." --Ray Bradbury
Posted by amethyst on 24-07-2014 at 21:12:
Okay, this is why MBAs need to get out of medicine, education, and other specialized services. The person running the hospital or insurance company is likely better qualified to rob us blind in a hedge fund than tell doctors and nurses how to do there job.
The bottom line is there should be no bottom line when it comes to human beings. He who dies with the most toys loses just like everyone else.
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Perspective Alters Reality
Posted by ElectricWhite on 31-07-2014 at 16:45:
Well, the front of my leg has improved considerably while the back of my leg still looks like a nasty burn that's mildewed. (I suppose that's to be expected -- the wound started in the back, and that's where the bulk of the watery discharge came from.)
Now it's a matter of sitting back and letting the fancy bandaging do its job.
__________________
“There are worse crimes than burning books. One of them is not reading them." --Ray Bradbury
Posted by ChrisW on 31-07-2014 at 19:24:
Glad to hear that it's improving!!!!!
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Posted by Redbird on 31-07-2014 at 22:53:
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Ditto, EW.
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